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How can we tell if teenagers are responding to HIV/AIDS awareness campaigns? Is it acceptable to conduct randomised trials in schools to find out? University College London, together with the University Zimbabwe and the London School of Hygiene and Tropical Medicine, looked into the sensitive topic of interviewing and testing teenagers for sexually-transmitted diseases (STDs) including HIV, in a feasibility study for a large community randomised trial. It found that communities in Zimbabwe were enthusiastic about taking part in trials in schools and recognised the importance of these.
Teenagers in sub-Saharan Africa are one of the most important groups for HIV/AIDS awareness campaigns. Many programmes have been aimed at this age group over the past twenty years, but are they effective? This information is essential if the campaigns are to become more widespread. While randomised trials are the best way of measuring the effectiveness of behaviour change programmes, there are ethical considerations to involving minors in this type of research.
In this feasibility study, conducted in rural Zimbabwe, parents gave written consent to their child's participation (children were aged between 12 and 18). The HIV and STD testing was carried out anonymously to encourage pupils’ participation.
The study found that:
Some parents did not give consent. This was either because some simply did not receive the form from their child, or that, particularly those who are illiterate, felt they did not have enough information about the study. The report recommends that in the event of a large community controlled trial being conducted:
The study found it was acceptable to carry out randomised trials in schools as long as the local communities are involved. However, teenagers are unlikely to be honest about their sexual experience. A more reliable method would be biological evidence, such as urine samples.
‘School based HIV prevention in Zimbabwe: feasibility and acceptability of evaluation trials using biological outcomes’, AIDS 16: 1673-1678, by Frances Cowan et al, 2002
HINARI subscribers can access the full-text article here. Full document.
Funded by: The Wellcome Trust
id21 Research Highlight: 24 April 2003
Department of Sexually Transmitted Diseases
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